Intraoperative marking of overlay graft: A simple technique to pass a malleus through a hole

Objectives: To prevent lateralization of the graft, one of the most serious complications of myringoplasty or tympanoplasty, it is very important to place a graft medial to the malleal handle or to exteriorize a part or total handle of the malleus. In the grafting technique for which a part of the malleal handle is exteriorized by making it pass through a hole created in the fascia graft, it is the key point to clearly identify the hole made on the temporalis fascia and to quickly pass the malleal handle through a hole. Now we present here a simple surgical tip to identify the hole easily and facilitate passing the malleal handle through it. Setting: Retrospective review; university-based hospital. Subjects: Sixty-seven cases of overlay myringoplasty or tympanoplasty. Results: Because our technique can allow the surgeon to better see the hole and to better handle the graft, it is useful regardless of the experience of the surgeon. In addition, any adverse effect of gentian violet has not reported in our cases. Conclusion: Our technique allows the clear identification of a hole on the temporalis fascia and helps the malleal handle pass much easier through a hole. Such improved identification of a hole can be very helpful for trainee residents or less-experienced surgeons. Copyright 2005